In the last decade or so, the practice of packed red blood cell (PRBC) transfusions
in critically ill patients has become the subject of many investigations. Once regarded
as a relatively safe and effective means of increasing oxygen delivery, it has become
clear that there are several aspects of blood transfusion that are not understood
completely. Many investigators and clinicians feel that more scrutiny of this practice
is warranted given an increased awareness of blood-borne pathogens, evidence that
allogeneic PRBCs may lower susceptibility to infection [
1
,
2
,
3
,
4
,
5
,
6
,
7
], and the ever increasing consumption of blood products by a growing critical care
population. Additionally, studies on the pathogenesis and treatment of septic shock
have shown conflicting data on the benefits of augmenting oxygen delivery with allogeneic
PRBCs [
8
,
9
,
10
,
11
,
12
]. In the last several years, many important studies have been published that not only
cast doubt on the benefits of PRBC transfusion but also have sought to redefine the
optimal threshold value of hemoglobin (HGB) concentration that warrants transfusion.
Recently, there have been two large descriptive studies that sought to describe the
current practice of PRBC transfusion in intensive care units (ICUs) and correlate
that information with clinical outcomes. This article reviews these studies of current
transfusion practices and tries to use this information as a guide to effective transfusion
practice.To read this article in full you will need to make a payment
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© 2004 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
